Patient Portals Aren't Very Patient Centric

It's time to put some excitement and creativity into e-patient education.

Since the introduction of the Meaningful Use Incentive Program, many hospitals and medical practices have been working hard to meet Stage 1 and 2 regulations on patient engagement.

In Stage 1 MU, for instance, providers have had to provide patients with electronic copies of their diagnostic test results, medication lists, allergies, discharge summary, procedures, and related information -- if they request them. They've been required to provide this information to more than half of all patients who request it within three business days.

Stage 2 takes patient engagement to the next level. The regs say more than 50 percent of all unique patients seen by clinicians (those who the rules refer to as eligible professionals) should be offered timely online access to their health information. More than 5 percent of all unique patients seen by a health professional actually have to view, download, or transmit their data to a third party.

Many practices attempt to meet these requirements by setting up a web portal where patients can access this information. But frankly, a lot of offices aren't making patient engagement a top priority.

The portals that many practices have set up are plain-vanilla snoozefests, offering basic statistics, current medications, upcoming appointments, and the like. There is so much that practices could do on these sites to grab a patient's attention and provide much needed education on a variety of important issues.

David Chase, an e-patient education specialist whose work I admire, recently discussed the efforts of several physicians who know how to make portals patient centric. Granted, most offices don't have the deep pockets to create the kind of impressive portals that Kaiser Permanente and the Cleveland Clinic have assembled. Nonetheless, with the help of an IT consultant -- or a tech-savvy co-worker -- even small practices can wow their patients -- often on a shoe-string budget.

Chase mentions Wendy Sue Swanson, MD, for instance, who uses YouTube videos and blogs to create content on growth charts and vaccines. There's also Ryan Neuhofel, MD, who has learned enough about video production to create engaging tutorials on hemoglobin A1c, the lab test used to monitor diabetes. Similarly, Howard Luks, MD, has done an impressive job of creating videos to explain various orthopedic procedures for his patients.

These videos aren't Hollywood productions, just bare bones educational tools. But they certainly do more than present the dry fact, and producing these tutorials doesn't require a degree in computer science.

But to be fair, many physicians are so busy trying to care for patients and so overwhelmed with new federal regulations and insurance red tape they can't find the time for even these no-frills additions to their patient portals. What they really need is a tool that would make e-patient education almost effortless, which begs the question: Where's the killer app that will transform patient engagement?

If iTunes can revolutionize the music industry and Netflix can turn the video entertainment industry on its head, why hasn't some disruptive, irreverent entrepreneur shaken up the world of patient education yet?

Good article, Paul. There's a movement going on to integrate dashboarding APIs into current patient portals. This will help bring the current "plane-jane" look and feel of patient portals to the next level. Cipe is just one of the companies helping with the heavy lifting. Dashboarding from QlikView and Tableau will make patient portals more interactive in years to come (lab results over time, self documentation integrated into phr diagrams as examples), extending the time and interest patients spend interacting with providers.

I rarely comment on posts relating to my own business (as I don't like when people use our blog to self promote their agenda...), but you ended your article with a question asking where are those innovative entrepreneurs with a disruptive technology...

Well, I guess that this is what we are trying to do with Medivizor.com. Medivizor helps those coping with serious or chronic medical conditions. Once you create your free account (HIPPA compliant and secure - a must!), you are asked several questions about your specific case. Medivizor is then able to share with you on an ongoing, but not overwhelming, manner information which is specific to your case - i.e. only the info which is relevant to you, based on credible resource in and in words you can understand.

The reason you did not hear about us yet is because we are rather new (went to public beta in August...). So far feedback from users is great and what I find interesting is that recently clinics across the country have started to 'prescribe' Medivizor to thier patients as a credible source of personalized patient education. We have also received several endorsements from non-profit organizations and from various bloggers (e.g. cancer survivors).

As we are rather new, there is still a way to go, but so far we cover in terms of medical conditions, 88% of the new cancer incidents, 75% of cardiovascular cases, 100% of diabetes cases and infertility. We are adding the support for more and more medical conditions as we go.

I'd love to connect to chat some more. Regardless, as we recently started spreading the word about our service, I invite all to share and take us for a test drive. I hope we can help,

I certainly was not suggesting that your father, or anyone for that matter, is a simpleton. Rather, I am suggesting that the approach taken by many patient portal vendors appear to treat patients as if they in fact are simpletons. I documented my own "firt time" experience with my doctor's new patient portal on my blog. Read it and let me know if I am wrong in my opinion express above. Here's the URL http://wp.me/p3Dxul-13z.

Your comment about your dad brings up another point with respect to Meaningful Use and patient portals. Given the prevalance of chronic helath conditions among older folks and given the lack of exposure within this demographic to things IT-related, doesn't it seem a bit odd to expect to get even 5% of this market segment to go online to access data they probably already have in paper form at home?

Most patients are not simpletons. There's a difference between lack of intelligence and lack of knowledge. Take my father in law, for example. He's intelligent and has a deep technical knowledge of the printing industry. But at 85, he's never been exposed to the computer technology or lingo that 20 somethings take for granted. And he often feels intimidated by IT savvy friends who make him feel like an idiot. That only encourages him to remain ignorant.

The most sucessful medical providers will find ways to reach young and old, tech savvy and tech-naive with patient education and access that makes them want to engage. Off the shelf patient portal solutions aren't enough.

I don't know, I see a lot of simpletons at my local GPs. There's a touch screen system to log in for your appointment - this is advanced in the sticks - and the amount of people that look at it confused and then go to the help desk is staggering.

Kudos to physicians everywhere that are trying to make a differnce with patient portals. But please recognize that your patients are not simpletons and that they are already engaged in their health at least from their perspective. For portals like this to be successful – (meaning that patients actually use them more than once) – they need to offer real value (from the patient's perspective), they need to be relevant to patients (not you or your staff) and they need to respect my intelligence.

In understand that the getting reimbursed for your investement in your EMR software depends upon your meeting Stage 2 Meaningful Use which focrse you to offer a patient portal...but since you have one make the best use of it you can.

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